CN1964756A - A patient ventilating and aspirating system - Google Patents

Abstract

A patient ventilation (23) and suction system (8) is disclosed having a suction tube (9) and a connector (6) for connection to a catheter holder having a sealed passageway (15). The conduit stent passage (15) is sealed by a resilient seal (16) comprising perforations or slits (17). A connector (12) with a piercing part is connected to the suction pipe (9). When the connector is coupled to the catheter holder, the piercing member (20) pierces the seal (16) so that the suction tube (9) can pass through the connector (6) and the catheter holder.

Description

Patient Ventilation and Suction Systems

technical field

The present invention relates to catheter connectors and in particular but not exclusively to catheter connectors for suction systems for use with tracheostomy or endotracheal patient ventilation systems.

Background technique

Many medical procedures require the placement of a tracheostomy or endotracheal tube into the trachea to deliver air directly to the lungs. Patients ventilated in this way cannot cleanse themselves of secretions that collect in their lungs and airways on their own. To overcome this problem, a sterile flexible suction tube is inserted into the patient through a tracheostomy or endotracheal tube. The suction tube is used with an external vacuum source to create suction and help clear secretions. In the secretion removal method known as the open suction system, the suction tube is disposed of immediately after use because it has become contaminated with pathogens and bacteria that remain in the patient's airway, and once it is removed from the patient's airway , the tube would be exposed to the atmosphere, posing a risk of infecting the caregiver. An alternative to an open suction system is known as a closed suction system, in which the suction tube is enclosed in a sealed flexible plastic sheath while it is outside the patient's body, thus allowing the suction tube to be used multiple times and then Or replace it after a certain period, usually every 24 hours. A closed suction system provides a degree of protection from contaminants to anyone in contact with the patient, such as a caregiver, and similarly protects the patient from infection by the caregiver and the like. Since it was first introduced, various aspects of the closed system have been refined in order to improve the effectiveness of the system.

US 4,351,328 discloses a combined tracheostomy ventilation tube and open patient suction system. The disclosed device has the disadvantage that the suction catheter is exposed to the atmosphere before it is advanced through the tracheostomy tube into the trachea. As the catheter penetrates the seal, the catheter also contacts the outer portion of the seal, allowing the catheter to pick up bacteria on the outer surface of the ventilator before it accumulates in the patient's lungs. A further disadvantage of this system is that the resistance of the catheter to passing and past the seal is relatively high and will cause some discomfort to the patient when the tracheostomy tube and other fittings are inadvertently moved and twisted to overcome this resistance.

US 4,569,344 discloses a combined tracheostomy ventilation tube and closed patient suction system. The disclosed device has the disadvantage that when the connector is loosened to perform routine cleaning or maintenance or to replace the suction system, the vent tube is not sealed so that bacteria carried by the outside air can enter the trachea through the vent tube middle. Also, it is difficult to maintain PEEP (positive end-expiratory pressure) within the system if the system is not sealed, such as is the case when the connector is loosened. If PEEP is not maintained throughout this system, not only will this affect the patient's ventilation, but in the most common form of tracheal tube deployment, an inflatable cuff is used to hold and seal the tracheostomy in place in the patient's trachea Tube ventilation and suction cannula. If PEEP is lost, the cuff can deflate, allowing subglottic fluid pooled on the cuff to leak into the patient's lungs. The device disclosed in this specification also has the disadvantage that, before connection, the end of the catheter is completely exposed and when it is advanced into the trachea comes into contact with the exposed portion of the outer surface of the ventilator, resulting in further risk of infecting the patient. Big chance.

US 5,060,646 discloses a similar closed system for ventilation and suction. This system has the disadvantage that without opening the ventilation system, the aspiration assembly containing the catheter cannot be removed for replacement or maintenance, making it difficult to maintain PEEP and may allow airborne bacteria to enter the system. At the same time, in this case, the catheter can be inserted into the ventilator without touching the outer surface, which only happens when the ventilator is unpacked, and has the drawbacks mentioned above. Also, removal and attachment of the suction assembly is performed through a resistance fit, so as mentioned above, the patient is uncomfortable with the increased possibility of twisting and pulling.

Contents of the invention

It is an object of the present invention to provide a ventilation and suction device which overcomes one or more of the above-mentioned problems or disadvantages, or which at least provides the public with a useful choice.

In a first aspect, the present invention provides a patient ventilation and suction system comprising:

source of pressurized gas,

a gas delivery device adapted to deliver said gas to said patient in use,

a patient connector adapted to deliver said gas to a patient through a tracheostomy or endotracheal tube connector, said patient connector being adapted in use to be in fluid communication with said gas delivery device,

a catheter holder, substantially tubular and adapted to fit in use between said patient connector and said gas delivery device, said catheter holder comprising an additional passageway for receiving a suction system, said passageway being sealed cover, the seal includes a resealing mechanism, and

a suction tube having a distal end and a proximal end, surrounded by a retractable envelope, the distal end being fitted with a distal connector, the proximal end movable through a proximal connector coupled to the envelope, the a distal connector adapted to allow said distal end of said suction tube to be connected to a suction device in use, said proximal connector being releasably connected to said catheter holder, said proximal connector comprising a piercing member capable of piercing the seal when the proximal connector and catheter holder are connected, the suction tube being able to pass through the piercing member without contacting the seal .

In a second aspect, the present invention provides a suction tube and connector for connection to a catheter support having a sealed passageway comprising:

tube, which has a distal end and a proximal end,

a retractable envelope around said tube,

a distal connector fitted to said distal end and adapted in use to allow said distal end of said suction tube to be connected to a suction device,

a proximal connector coupled to the cuff through which the proximal end of the tube is movable,

the proximal connector is releasably connected to the catheter holder,

a piercing member capable of piercing the seal and through which the suction tube can pass without contacting the seal.

Description of drawings

Preferred forms of the invention will be described below with reference to the accompanying drawings.

Figure 1 shows, for example, a patient's ventilation circuit in use with which the present invention may be used, in particular showing the use of elbow connectors (elbow connectors), catheters and tracheostomy or endotracheal connectors. Suction assembly of the present invention.

Fig. 2 is a detailed view of the suction assembly, catheter and elbow connector of Fig. 1, also showing the patient and the ventilation tube connecting the suction assembly to the suction pump.

Figure 3 is a detailed view of the suction assembly showing the conduit and elbow connector detached from the suction assembly.

Figure 4 is a further detail view of the conduit and elbow connector having a resilient seal provided with perforations and a bayonet fitting for connecting the two components.

Figure 5 is a detailed cross-sectional view of the proximal connector coupled to and into the catheter showing the dead space or dead space created when the suction assembly is coupled to the catheter with the catheter passing through the center protrusion and seal .

Figure 6 shows an alternative embodiment of the catheter of the present invention wherein a bifurcated y-shaped tracheostomy connector is used instead of the catheter and the tracheostomy connector.

Figure 7 shows another alternative embodiment of the catheter of the present invention in which a cross or x-shaped joint is used instead of the T-shaped joint of the preferred embodiment.

Detailed ways

The invention consists of several separate components which are assembled together to form a system for ventilating and aspirating the patient 3 . The system comprises a tracheostomy or endotracheal connector 1 (hereinafter referred to as "patient connector 1") which, in use, is coupled to a tracheostomy located in the neck or larynx of a patient 3. Oral or endotracheal connector 2. In the figures, the patient is only shown with a tracheostomy connector and not an endotracheal connector and tube. The elbow connector 6 and the catheter 4 are connected together to form a catheter bracket. The elbow connector 6 is coupled to the patient connector 1 . There is also a suction assembly 8 coupled to the elbow connector 6 . Conduit 4 is actually a length of tubing that connects elbow connector 6 to a ventilation system that supplies gas into the patient's airway.

In the preferred embodiment described above, the patient has had surgery and a tracheostomy or endotracheal connector 2 has been inserted into his or her trachea to allow ventilation and suction.

Referring to Figures 1 and 2, aeration and humidification systems that may be used with the suction tube connector of the present invention are shown. A patient 3 receives humidified and pressurized gas through a tracheostomy or endotracheal connection 2 (hereinafter referred to as "patient connection 2"). The conduit 4 is connected to a humidified gas delivery channel or suction line 7 which in turn is connected to a humidifier 25 supplied with gas from an aerator 23 . Exhalation conduit 24 delivers gas from the patient back into the ventilator to assist patient 3 in breathing. Composition of the aeration and humidification system The aerator 23, humidifier 25 and piping 24 are known in the prior art and may be of the type described in US 5,640,951 to Fischer and Paykel Ltd.

The suction assembly 8 consists of a suction tube 9, a retractable flexible (soft) plastic envelope 10 and at least two joints at each end, in particular the distal joint 11 and The proximal connector 12 closest to the patient 3 . The suction tube 9 is able to slide back and forth through the proximal connector 12 so that in use the cuff 10 contracts and expands longitudinally by movement of the suction tube 9 . The proximal connector 12 has a releasable connector mechanism to allow coupling to the elbow connector 6 and thus to the catheter 4 . The plastic envelope 10 contains any hazardous biological waste from the lungs of the patient 3 that may have accumulated outside the suction tube 9 . The distal joint 11 is connected with a suction pump 13 . The suction generated from the pump 13 is used to draw fluid from the lungs and airway passages of the patient 3 through the suction tube 9 .

To pass the inhalation tube 9 into the lungs and airways of the patient 3, its length can be pushed through the proximal connector 12, through the elbow connector 6, the patient connector 1 and the patient connector 2, and then into the lungs of the patient 3 . In order to prevent blockage of the patient's airway, the suction tube 9 is not left inside the patient 3 when not in use. Thus, when not in use, the suction tube 9 is essentially retracted through the proximal connector 12 and into the plastic envelope 10 . The plastic envelope 10 can be stretched around the suction pipe 9 because of the presence of small holes 31 (see FIG. 3 ) which allow the venting of air and thus allow the envelope to be collapsed and filled with air.

Proximal connector 12 releasably connects suction assembly 8 to elbow connector 6 . In the preferred embodiment shown in Figures 3 and 4, the elbow connector 6 and the conduit 4 are substantially T-shaped in cross-section. The upright portion of the T-section is formed or connected to the vent pipe 4 . The end of the arm of the T-section forms or connects to the patient connector 1 and the other end forms a channel 15 which receives the proximal connector 12 of the suction assembly 8 . A seal 16 is located at the outermost end of the channel 15 and seals the channel 15 . In the preferred embodiment, the seal is a resilient material (or elastomeric material), such as silicone rubber, and has a slit 17 formed in the center of the seal. This slit 17 allows the seal 16 to be pierced, eg by the central projection 20 (to be described below) or the suction tube 9, but then resealed once the object that pierced the seal has been removed.

In other forms of elbow connectors and conduits, an L-shaped configuration may be used, wherein a hole may be provided in the corner of the L, with the elastomeric seal disposed in the hole. In this configuration, the channel 15 will be shorter in length.

Referring now to FIG. 5 , the proximal connector 12 consists of two nested cup fittings, an inner cup fitting 18 and an outer cup fitting 19 extending around a central protrusion 20 . The central protrusion 20 preferably protrudes beyond the edge 28 of the outer cup joint 19 , although this is not strictly necessary for the protrusion 20 . The edge 28 of the outer cup joint 19 protrudes beyond the edge 27 of the inner cup joint 18 . The outer cup joint 19 preferably has an inner diameter slightly larger than the outer diameter of the elbow connector 6 forming the channel 15 . The inner cup joint 18 has a slightly smaller diameter than the outer diameter of the lateral portion of the elbow connector 6 . Proximal connector 12 and elbow connector 6 are brought together and connected such that central protrusion 20 passes through slit 17 in elastomeric seal 16 and into channel 15 . The edge of the inner cup joint 18 abuts the end of the channel 15 . A dead space (dead space) 21 is formed inside the inner cup joint 18 between the outer surface of the seal 16 and the outer surface of the protrusion 20 . When the elbow connector 6 and the suction assembly 8 are connected in this way, it is not necessary to consider that the seal is airtight and prevents gas from leaking into the atmosphere, because the sealing occurs at the end of the seal 16 and the inner cup joint 18 Section 27 between. In any case, any possible leakage that may occur is contained in the dead space 21 formed by the connection. When the elbow connector 6 and the suction assembly 8 are brought together, the dead space 21 interrupts the direct path between the gas flowing through the seal 16 and the atmosphere. Once the rim 27 of the inner cup joint 18 has been pushed against the seal 16 at the end of the channel 15, the rim 27 of the inner cup joint 18 and the seal 16 form a seal which prevents further leakage to atmosphere.

As the inner cup joint 18 abuts the seal 16 , a portion of the outer cup joint 19 overlaps and surrounds the outer end portion 29 of the channel 15 . Channel 15 and external cup fitting 19 are fitted by a releasable lockable bayonet fitting 22 of a type known in the art. The bayonet fitting 22 prevents inadvertent release of the proximal connector 12 from the elbow connector 6 .

In the preferred embodiment, the central projection 20 is a hollow tube protruding from the proximal connector 12 . The conduit 9 fits tightly in the central protrusion 20 and slides easily therein. This tight fit has the advantage that little or no gas leaks or escapes through the seal 16 to pass between the conduit 9 and the central protrusion 20 . An additional seal or gasket 30 in the proximal connector 12 prevents gas from entering the cuff 10 in the event of a gas leak. The seal or gasket 30 also performs a wiping action around the suction tube and prevents excess mucus, contamination, etc. from entering the envelope 10 .

In some forms of the invention, wrapper 10 may be formed from a breathable material, such as SYMPATEX ^™ .

In use, when proximal connector 12 mates with elbow connector 6 , protrusion 20 is pushed through slit 17 in seal 16 and proximal connector 12 is locked to the elbow by bayonet fitting 22 on connector 6. The end of the suction tube 9 can then be pushed through the hollow center of the central protrusion 20 into the elbow connector 6 and then into the patient connector 1 , the patient connector 2 and into the lungs of the patient 3 . After the suction operation has been completed, the suction tube 9 can be withdrawn backwards through the proximal connector 12 and any contamination located on the outer surface of the suction catheter 9 can be safely contained in the plastic envelope 10 .

Once the suction assembly 8 and elbow connector 6 have been mated, there is little or no inadvertent force or twisting of the elbow connector and conduit 4 to push the suction conduit 9 through the seal 16 . The suction conduit 9 is easily movable in the tube formed by the central protrusion 20 . Therefore, the system of the present invention can reduce the degree of patient injury. The features of seal 16 and proximal connector 12 described above also ensure that any gas leakage through seal 16 does not result in excessive loss of PEEP.

In the preferred embodiment of the invention described and shown in the drawings, the patient connector 1 is connected to the elbow connector 6 or may be an integral part of the elbow connector 6 . This is a common example of this type of ventilation circuit, although a bifurcated y-shaped tracheostomy joint 5 of the type shown in Fig. 6 allowing an independent connection of the elbow connector 6 and the catheter 4 is known.

A similar alternative system is shown in FIG. 7 , where the suction assembly 8 is coupled to a cross or x-shaped conduit 26 . One branch of the conduit 26 forms the channel 15 and the opposite branch forms the patient connector 2 . In this embodiment, one side branch forms the inspiratory conduit 7 and the opposite branch forms the discharge expiratory conduit or the expiratory conduit 24 leading back to the ventilator 23 (if used in an assisted breathing configuration).

Systems of the above type in preferred embodiments and alternatives with a bifurcated y-shaped tracheostomy connector 5 or an x-shaped catheter 26 have the advantage that they are modular and separate parts such as the elbow connector 6 Alternatively the suction assembly 8 can be easily removed from the system and replaced if necessary. This is especially useful as the suction assembly 8 will likely need to be removed and replaced more frequently than other components.

Claims (13)

1. A patient ventilation and suction system comprising: source of pressurized gas, a gas delivery device adapted to deliver said gas to said patient in use, a patient connector adapted to deliver said gas to a patient through a tracheostomy or endotracheal tube connection, said patient connector being adapted in use to be in fluid communication with said gas delivery device, a catheter holder, which is substantially tubular and adapted to fit in use between said patient connector and said gas delivery device, said catheter holder comprising additional passages for receiving a suction system, said passage being provided by covered by a seal including a resealing mechanism, and a suction tube having a distal end and a proximal end surrounded by a retractable envelope, the distal end being fitted with a distal connector and the proximal end being movable through a proximal connector coupled to the envelope, the The distal connector is adapted to allow the distal end of the suction tube to be connected to a suction device in use, the proximal connector is releasably connected to the catheter support, and the proximal connector includes a piercing member capable of piercing the seal when the proximal connector and catheter holder are connected, the suction tube being able to pass through the piercing member without contacting the seal . 2. The patient ventilation and suction system of claim 1, wherein the proximal connector is configured such that when connected to the catheter support, a chamber is formed surrounding the The sealing device described above and a dead space is created therein. 3. The patient ventilation and suction system of claim 2, wherein said proximal connector and said catheter support are configured such that when connected, an adjacent surface on said proximal connector is in contact with The conduit mounts abut to form a seal and prevent gas that leaks through the seal into the chamber from expelling to the atmosphere. 4. A patient ventilation and suction system according to any one of claims 1 to 3, wherein said connection between said catheter support and said proximal connector is a bayonet fitting. 5. A patient ventilation and suction system according to any one of claims 1 to 4, wherein the seal is made of a resilient material and provides a substantially airtight seal under normal operating pressure. 6. The patient ventilation and suction system of claim 5, wherein the seal includes perforations that allow the piercing member to pierce the seal, wherein once the proximal end The adapter is detached from the catheter holder and the resilient material again seals the pathway. 7. The patient ventilation and suction system of claim 2, wherein said chamber and said dead space are shaped such that said seal may leak through said seal after being pierced. Gas in the gas delivery conduit is surrounded and contained within the dead space. 8. A patient ventilation and suction system according to any one of claims 1 to 7, wherein said passage through said catheter support allows for a Pass the suction tube through and into the tracheostomy or endotracheal connector if necessary. 9. A patient ventilation and suction system as claimed in any one of claims 1 to 8, wherein said proximal connector includes a gasket for Wipe down the suction tube. 10. A suction tube and connector for connection to a catheter holder having a sealed passageway comprising: tube, which has a distal end and a proximal end, a retractable envelope around said tube, a distal connector fitted to said distal end and adapted in use to allow said distal end of said suction tube to be connected to a suction device, a proximal connector coupled to the cuff through which the proximal end of the tube is movable, the proximal connector is releasably connected to the catheter holder, a piercing member capable of piercing the seal and through which the suction tube can pass without contacting the seal. 11. The patient ventilation and suction system of claim 10, wherein the proximal connector is configured such that when connected to the catheter support, a chamber is formed surrounding the The sealing device described above and a dead space is created therein. 12. A patient ventilation and suction system as herein described with reference to the accompanying drawings. 13. A suction tube and connector as herein described with reference to the accompanying drawings.

Images